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Are You There for Me? Joint Engagement and Emotional Availability in Parent–Child Interactions for Toddlers With Moderate Hearing Loss

Dirks, Evelien1,2; Rieffe, Carolien1,2,3

doi: 10.1097/AUD.0000000000000596
Research Article

Objectives: This study examined joint engagement and emotional availability of parent–child interactions for toddlers with moderate hearing loss (MHL) compared with toddlers with normal hearing (NH) and in relation to children’s language abilities.

Design: The participants in this study were 25 children with MHL (40 to 60 dB hearing loss) and 26 children with NH (mean age: 33.3 months). The children and their parents were filmed during a 10-minute free play session in their homes. The duration of joint engagement and success rate of initiations were coded next to the level of emotional availability reflected by the Emotional Availability Scales. Receptive and expressive language tests were administered to the children to examine their language ability.

Results: Groups differed in joint engagement: children with MHL and their parents were less successful in establishing joint engagement and had briefer episodes of joint engagement than children with NH and their parents. No differences between groups were found for emotional availability measures. Both joint engagement and emotional availability measures were positively related to children’s language ability.

Conclusions: Children with MHL and their parents are emotional available to each other. However, they have more difficulties in establishing joint engagement with each other and have briefer episodes of joint engagement compared with children with NH and their parents. The parent–child interactions of children with better language abilities are characterized with higher levels of emotional availability and longer episodes of joint engagement. The results imply that interactions of children with MHL and their parents are an important target for family-centered early intervention programs.

1Department of Developmental Psychology, Leiden University, Leiden, the Netherlands

2Dutch Foundation for the Deaf and Hard of Hearing Child, Amsterdam, The Netherlands

3School of Psychology and Human Development, Institute of Education, University College London, London, United Kingdom.

Received July 17, 2017; accepted March 16, 2018.

The authors have no conflicts of interest to disclose.

Supplemental digital content is available for this article. Direct URL citations appear in the printed text and are provided in the HTML and text of this article on the journal’s Web site (

Address for correspondence: Evelien Dirks, Developmental Psychology, Leiden University, P.O. Box 9555, 2300 RB Leiden, the Netherlands. E-mail:;

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